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General NPI Number Information
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NPI Number | 1174839674
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Entity Type | Organization
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Legal Business Name | B. RYAN FLEMING, DDS, PA
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Dates
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Enumeration Date | 08/23/2010
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Last Update Date | 08/23/2010
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Provider Practice Location Address
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Address Line | 14 LOCKWOOD DR SUITE A
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City | CHARLESTON
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State | SC
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Zip | 29401-1126
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Country | US
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Telephone | 843-722-8500
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Fax | 843-720-8555
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Provider Business Mailing Address
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Address Line | 14 LOCKWOOD DR SUITE A
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City | CHARLESTON
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State | SC
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Zip | 29401-1126
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Country | US
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Telephone | 843-722-8500
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Fax | 843-720-8555
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Authorized Official
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Title or Position | BUS MGR
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Name | JANELL CARLOW
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Credential |
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Telephone | 843-722-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1313
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4689
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License Number State | SC
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